The Irish Examiner newspaper today carried this story about an American lawyer who was let back into the US despite being red-flagged as a health risk.
It would seem that he had acquired a particularly nasty drug-resistant form of Tuberculosis – a diagnosis which was confirmed in Europe where he was travelling. He was advised not to travel and to seek treatment. Being a sensible personal injury lawyer with an understanding of duty of care to others who might be harmed by his actions and causal chains in litigation, he jumped on the next flight out.
Despite warnings from US health officials not to board another long flight, he flew home for treatment, fearing he would not survive if he did not reach the US, he said. He said he tried to sneak home by way of Canada instead of flying directly into the US.
When he got to the US/Canadian border his passport swipe popped a big red flag that advised the Border guard to restrain him, to prevent him from entering the US and to don a protective mask when dealing with this lawyer. The border guard promptly waved him through, despite the medical advice to hold him and quarantine him, because…
the infected man seemed perfectly healthy and that he thought the warning was merely “discretionary”.
While the guard is not a doctor, their future career as a border guard may also be in question (they are currently on ‘administrative duties’). The union representing the guard in question has gone on record saying that “public health issues are not receiving adquate attention and training” within the Dept of Homeland Security.
The right information was in the right place at the right time. It was accurate. However through a disregard for process the information was without value and the border security process didn’t work as expected. That disregard for process may have had a root cause in a failure of training to either cover the public health issue or a failure of the organisation to emphasise that the role of Homeland Security is to protect against threats – not just terrorist ones.
The issue here is not the completeness etc. of the information. All the facts that appear to have been needed were in place. However, without an effective process to put those facts in context and take action, those facts remained simply pieces of data.
The systems may have flashed the right colours on the screen or beeped in a ‘danger will robinson’ kind of way, but if the process could be ignored or over-ridden without reference to those facts then a trainwreck results.
Quality of outcome results from quality of information and quality of process (in my opinion any way).
According to New Scientist 2007-07-14 p16 it wasnt the almost untreatable ” extensively drug resistant” (XDR) variant of TB but only the “multi-drug resistant” form, which can be treated.
Interesting update Keith. Looks like the quality of the information that was communicated in the media wasn’t up to scratch, or else the ‘red flagging’ of the lawyer in question was not actually required but the information about him was not accurate resulting in this problem (for the border guard).